Catch colonoscopy complications with CT—not radiography

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While complications from optical colonoscopy occur in less than 1 in 100 cases, the effects can be devastating; bleeding, infection, even death. In the rare case that a serious complication occurs, radiology administrators can ensure rapid diagnosis by prioritizing CT over abdominal radiography, according to a study published in the Journal of the American College of Radiology.

With more than 14 million colonoscopies performed each year in the U.S., and an aging population, the gross number of complications is only rising. Up to a third of patients will complain of transient symptoms after an optical colonoscopy; most of these are minor and will quickly fade. However, in the event that abdominal pain persists for hours or days after the procedure, a trip to the emergency department is required.

“Most CT examinations obtained after colonoscopy show no acute abnormality,” wrote Beth Israel Deaconess’ Robin Levenson, MD, et al. "However, given the large number of optical colonoscopies performed annually, even though serious complications are relatively rare, radiologists will eventually see them."

While abdominal radiography has been the traditional diagnostic tool in this situation, CT offers greater detail regarding conditions such as bowel perforation, post procedural hemorrhage and appendicitis. A quick diagnosis is essential to the successful management of colonoscopy complications, due to the substantial bleeding that can occur.

“Although post colonoscopy complications are infrequent, radiologist awareness of these complications and the associated imaging findings is essential for optimal diagnosis and prompt management,” wrote Levenson et al.